Purpose The purpose of this study was to determine the effects of the Otago exercise program on fall efficacy, activities of daily living, and quality of life in elderly stroke patients. Subjects and ...Methods Eight subjects performed the Otago exercise program three times per week, for 8 weeks. The outcome measures were the Fall Efficacy Scale score for fall efficacy, modified Barthel index for activities of daily living, and EQ-5D for quality of life. Results In our comparison of the results before and after the intervention, we found that the Otago exercise program improved fall efficacy significantly as well as the score for activities of daily living and quality of life, though not significantly. Conclusion We consider that the Otago exercise program is an effective method for improving fall efficacy in elderly stroke patients.
Introduction: Balance impairments and an increased fall risk are common concerns among individuals with various health conditions. Resistance exercise has shown potential in improving balance and ...reducing fall risk. Aim: To determine the effects of home-based Thera-Band resistance training in reducing the risk of falls among the geriatric population and to compare it with weight-cuff resistance training. Materials and Methods: A Randomised Controlled Trial (RCT) was conducted at the Amity Institute of Health and Applied Science, Noida, India, from November 2022 to April 2023. The intervention period spanned four weeks, and a total of thirtythree subjects were enrolled in the study. The participants were divided into three groups: Group A, Group B, and Group C. Group A performed resistance exercises using weight cuffs combined with standard balance training, Group B performed resistance training with Thera-Band combined with standard balance training, and Group C received standard balance exercises alone. The effects of the interventions on fall risk reduction were assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG), and Fall Efficacy Scale (FES) among the geriatric population. Paired t-tests were employed to compare pre- and post-intervention data within each group, determining significant changes within each group over the intervention period. Analysis of variance (ANOVA) was utilised to assess between-group effects of the different interventions. Results: The FES scores were assessed pre- and postintervention for each group. Group B (Thera-Band) demonstrated significantly better outcomes in fall efficacy compared to Group A (Weight-cuff) (p<0.01) and Group C (p<0.01). For balance assessment using the BBS, both Group A and Group B showed better results compared to Group C (p<0.01). In terms of mobility assessed through the TUG test, Group B exhibited substantial improvement compared to both Group A and Group C (p<0.05). Improvements in fall efficacy, balance, and mobility were seen in Group B (Thera-Band). Conclusion: Home-based resistance training using TheraBand was found to be the most effective method for reducing the risk of falls in the geriatric population, followed by weightcuff resistance training in combination with conventional balance training. Thera-Band is not only effective but also more convenient, hassle-free, and cost-effective. The geriatric population should be provided with more multi-mode exercises that are easy to perform and have been found to be effective and helpful at their advanced age.
In people with moderate hip osteoarthritis, gait kinematics was reported to be correlated with number of falls in the preceding year. After Total Hip Arthroplasty, subjects generally improve but ...still fall. The present study explores recovery and correlations with number of falls in the year after Total Hip Arthroplasty.
We assessed 12 patients one year after Total Hip Arthroplasty, 12 patients with moderate hip osteoarthritis with at least one fall in the preceding year, and 12 healthy peers. Maximum hip abduction strength, Fall Efficacy Scale - International, Harris Hip Score, pain, and number of falls in the preceding year were assessed. Participants walked on a treadmill with increasing speeds, and gait kinematics were registered optoelectronically. We assessed group differences, and correlations of all variables with number of falls.
After arthroplasty, subjects tended to score better on variables measured, often non-significantly, compared to subjects with moderate osteoarthritis, but worse than healthy peers. Maximum hip abduction strength together with fall efficacy had a strong regression on the number of falls in the preceding year (R2 = 92%). Gait kinematics did not correlate with number of falls, and also fall efficacy was not related to gait kinematics.
One year after hip arthroplasty, muscle strength sufficiently recovered for normal walking, but not to avoid falling in risky situations. Rehabilitation should focus on muscle strength. The lack of correlation between the Fall Efficacy International and gait kinematics, suggests that it reflected the experience of having fallen rather than fear.
•We studied subjects one year after Total Hip Arthroplasty for osteoarthritis.•The subjects appeared to have recovered incompletely, and still fell.•Walking was quite normal and gait kinematics did not correlate with number of falls.•There was a strong relationship between muscle weakness and number of falls.•Which suggests a need for force rehabilitation after Total Hip Arthroplasty.
Background
The Sensory Organization Test (SOT), an integral part of computerized dynamic posturography, plays a crucial role in evaluating postural stability under various altered sensory conditions. ...Despite its importance, there have been noted inconsistencies in the results pertaining to equilibrium and sensory system evaluations. This study aimed to compare four sensory analysis scores and equilibrium indices between older adults with and without fall risks.
Methods
The study included 34 participants identified as being at risk of falls and 42 control subjects. To categorize individuals between the two groups, we performed area under the receiver operating characteristic curve analyses. This classification was based on scores from the Modified Falls Efficacy Scale (MFES) and the composite scores obtained from the SOT. In addition, we used the Tampa Scale for Kinesiophobia (TSK) as well as the level of disability.
Results
The fall risk group demonstrated significantly higher TSK scores (39.39 ± 15.24 for control group vs. 54.65 ± 10.70 for fall risk group; t = −5.09, p = 0.001). The groups demonstrated a significant interaction on the equilibrium index (F = 4.59, p = 0.03), which was lower in the fall risk group in Condition 6 with a moving surface and surround and eyes open (t = 2.29, p = 0.01). The fall risk group demonstrated a higher somatosensory score (t = −1.73, p = 0.04).
Conclusions
The fall risk group had a lower equilibrium index score in Condition six of the SOT, which was useful for identifying deficits in vestibular function to integrate sensory information under challenging conditions for postural adaptation. This strategy suggested that the fall risk group could compensate for their risk of falls by utilizing more effective somatosensory reweighting strategies compared with the control group.
To appraise research evidence on the effects of balance training on balance and fall efficacy in patients with osteoporosis.
Six electronic databases were searched from inception of the database to 1 ...August 2022, with no language restrictions, and randomized controlled trials of balance training in patients with osteoporosis were included in this meta-analysis. Two authors independently screened and reviewed the articles and assessed the methodological quality using the Cochrane risk-of-bias tools. Trial sequential analysis was conducted.
A total of 10 randomized controlled trials with 684 patients were included. Three of the studies that were included had low risk of bias, 5 had moderate risk of bias, and 2 had high risk of bias. A meta-analysis demonstrated that balance training improves dynamic balance measured using the Timed Up and Go Test (mean difference (MD) = -1.86, 95% CI (-2.69, -1.02), Z = 4.38, p < 0.0001) and the Berg Balance Scale (MD = 5.31, 95% CI (0.65, 9.96), Z = 2.23, p < 0.03), static balance measured using One-Leg Standing Time (MD = 4.10, 95% CI (2.19, 6.01), Z = 4.21, p < 0.0001), and fall efficacy measured using the Falls Efficacy Scale International (MD = -4.60, 95% CI (-6.33, -2.87), Z = 5.20, p < 0.00001) were also significantly improved. Trial sequential analysis showed reliable evidence of the effects of balance training on dynamic and static balance improvement. The conclusions of this review are supported by the statistical and clinical significance of all outcomes in the meta-analysis, based on the advised minimal clinically significant differences and minimum detectable changes.
Balance training may be effective in improving balance ability and reducing fear of falling in patients with osteoporosis.
Abstract
Background
The Falls Efficacy Scale-International (FES-I) is a commonly used questionnaire to evaluate concerns about falling. We adapted a Taiwan Chinese version (FES-I
TC
) and evaluated ...its reliability and validity in community-dwelling elderly individuals. The discriminative validity was tested in relation to several known risk factors for fear of falling (FOF).
Methods
The questionnaire was adapted through translation, back-translation, and expert review processes. A convenience sample of 135 community-dwelling elderly individuals (at least 60 years old) completed the adapted questionnaire, and 31 of them had a retest within 7–10 days. Cronbach’s α and an intraclass correlation coefficient (ICC) were used to evaluate the internal consistency and test–retest reliability. Principal component factor analysis was performed to assess the factor-construct validity. The discriminative validity was tested in relation to demographic features, fall-related history and performances on three functional tests: timed up and go, four-stage balance and 30-s chair stand tests. Effect sizes were computed. Correlation coefficients between physical functional performance and FES-I
TC
scores were computed. Receiver operating characteristic curves were used to determine the cutoff point for the score to differentiate high and low concern of falling.
Results
The FES-I
TC
questionnaire had high internal consistency (Cronbach’s α = 0.94) and excellent test–retest reliability (ICC = 0.94). Principal component factor analysis yielded a two-factor model, with several items requiring high demand on postural control loading on factor 2. FES-I
TC
scores discriminated individuals with different ages, reporting FOF, reporting falls in the past year and using walking aids. However, FES-I
TC
scores did not differ between the participants who were at risk of falling and those who were not at risk based on functional test performance and there was no correlation found between them.
Conclusion
The FES-I
TC
was highly reliable and had adequate construct and discriminative validity. The lack of correlation between FES-I
TC
scores and functional test performance implied the presence of FOF even in individuals with good functional performance. Further follow up studies are warranted to verify the predictive validity of the FES-I
TC
.
이 연구는 여성노인을 대상으로 전정-고유수용감각 운동을 통한 낙상관련 위험요인에 미치는 영향을 규명하는데 그 목적이 있었다. 대상자들은 65세이상 여성노인 24명(전정-고유수용감각 운동군 12명, 전정재활군 12명)을 선정하였으며, 전정-고유수용감각 운동은 양지(2016)와 황병준(2010)이 실시한 9988북부노인교실 운동프로그램과 김영아(2014)의 ...하지안정화 운동프로그램을 재구성하여 수행하였으며, 전정재활은 morimoto 등(2011)이 제시한 안구운동을 수행하였다. 운동 전 후 근지구력, 평형성, 협응력과 간편신체수행능력(Short physical performance, battery: SPPB), 한국형 노인 낙상효능감(Korea falls efficacy scale: FES-K), 건강관련 삶의 질(EQ-5D)을 측정하였다. 자료처리는 집단 및 측정 시기에 따른 상호작용 효과 검증을 위한 반복측정분산분석을 실시하였다(α≤.05). 연구 결과 근지구력, 평형성, 협응력에서 전정-고유수용감각 운동집단이 유의하게 향상되었으며(P.<01), 상호작용 효과도 나타났다(P<.05). 그러나, 간편신체수행능력에서는 유의한 차이가 나타나지 않았다. 그리고, 한국형 낙상효능감 척도와 건강관련 삶의 질에서 유의한 차이가 나타났으며(P<.01), 상호작용 효과도 나타났다(P<.05). 결론적으로, 전정-고유수용감각 운동프로그램은 여성노인의 낙상관련 체력적 요인과 심리적 요인에 대체로 긍정적인 영향을 미치는 것으로 나타났다. 따라서, 전정-고유수용감각 운동프로그램이 낙상에 취약한 여성노인을 대상으로 효과적임을 나타낸다.
The purpose of this study was to identify the effect of vestibulo-proprioception exercises on fall-related risk factors in elderly women. The subjects were 24 elderly women over the age of 65(12 in the vestibulo-proprioception exercise group, 12 in the vestibular rehabilitation group), and the vestibulo-proprioception exercise was performed by Yang Ji(2016) and Hwang Byeong-jun(2010) in the 9988 North. The elderly class exercise program and Kim Young-ah et al.,(2014) lower extremity stabilization exercise program were reconstructed and performed, and vestibular rehabilitation was performed using the gaze stability exercises suggested by Morimoto et al.,(2011). muscle endurance, balance, coordination, Short physical performance battery(SPPB), Korean falls efficacay scale(FES-K), and health-related quality of life(EQ-5D) were measured before and after exercise. for data processing, repeated measures analysis of variance was performed to verify interaction effects depending on group and measurement period(α≤.05). As a result of the study, the vestibulo-proprioception exercise group significantly improved muscle endurance, balance, and coordination(P.<01), and an interaction effect was also found (P<.05). However, there was no significant difference in short physical performance battery. Additionally, a significant difference was found between the Korean fall efficacy scale and health-related quality of life (P<.01), and an interaction effect was also found (P<.05). The results of the study showed that the vestibulo-proprioception exercise program had a generally positive effect on the physical and psychological factors related to falls in elderly women. Therefore, it shows that the vestibulo-proprioception exercise program is effective for elderly women who are vulnerable to falls.
A third of the population aged 65 and over experiences a fall during a given year, often with severe traumatic consequences, dependence, and consequently, a decline in quality of life. The fear of ...falling itself leads to avoidance behavior from daily activities leading to a downward spiral of dependence, loss of confidence, and therefore an increased risk of falling. Joint stiffness is often observed during clinical examination of elderly people. However, the association between lumbopelvic stiffness and fear of falling has not been studied.
Osteopathic manipulative treatment/medicine (OMT/OMM), targeted to improve the stiffness of the pelvic girdle, may improve the prognosis of patients afraid of falling and slow down their loss of autonomy.
We performed a prospective cohort study enrolling hospitalized patients and nursing home residents over 75 years of age. Patients able to walk and without significant cognitive impairment completed the International Fall Efficacy Scale (FES-I) questionnaire to assess their intensity of fear of falling. The modified Schober test and hip goniometry (flexion and extension) were measured and compared to the FES-I score.
A total of 100 patients were included. A high fear of falling (FES-I≥28) was associated with female sex (31 79.5 % vs. 29 47.5 %; p=0.002) and with a reduction in the amplitudes tested by the Schober test (2 1.5-3 vs. 3 2-4; p=0.002), the hip extension goniometry (7 4-10 vs. 10 7-15; p<0.001) and the hip flexion goniometry (70 60-77 vs. 82 71-90; p<0.001). The association between FES-I score and each anthropometric variable was strongly linear (p<0.001 for all), especially with hip flexion goniometry (R
=30 %).
Lumbopelvic stiffness, especially in hip flexion, is strongly associated with a high fear of falling in patients over 75 years of age. When combined with other movement-based therapies, OMM targeted to improve the stiffness of the pelvic girdle may improve the prognosis of patients afraid of falling and slow down their loss of autonomy.
: Balance impairment and fear of falling are two common risk factors for falls in people with multiple sclerosis (PwMS). Clinicians should use valid, reliable, and responsive tools to assess these ...risk factors and identify individuals at increased risk for falls. So, this study aimed to examine psychometric properties of the Persian-version of the Activities-specific Balance Confidence (ABC) scale and Fall Efficacy Scale-International (FES-I) in Iranian PwMS.
: One hundred and fifty-three PwMS completed the Persian versions of ABC, FES-I, Multiple Sclerosis Walking Scale-12 (MSWS-12), and Berg Balance Scale (BBS) in the first session. To assess the test-retest reliability, 50 PwMS filled out ABC, and FES-I in retest session with an interval of 2-7 days. Also, for evaluating responsiveness, 50 PwMS completed ABC and FES-I before and after a 4-week treatment.
: Intra-class Correlation Coefficients were 0.96 and 0.93 and Cronbach's alpha coefficients were 0.96 and 0.99 for the ABC and FES-I, respectively. There were significant correlations (
< .001) between ABC and BBS (r = 0.55), FES-I and BBS (r = -0.56), ABC and MSWS-12 (r = -0.72), and FES-I and MSWS-12 (r = 0.76). No floor or ceiling effect was found. ABC and FES-I had acceptable responsiveness (AUC > 0.70), and their minimally important difference (MID) were 10.5 and 9.5 points, respectively.
: The Persian-versions of ABC and FES-I are reliable, valid, and responsive measures to quantify balance confidence and fear of falling in PwMS at both clinical and research settings. The MID can help clinicians to make a decision based on the clinical significance of changes in patients' status.
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